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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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BROOKOVER, AMY KAY       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1000 W BOISE CIRCLE
BROKEN ARROW OK 74012

Address last updated on 3/25/2024
Phone #: (918) 994-8000
Fax #:
County: TULSA
License: 949
Dated: 4/1/1999
Expires: 3/31/2025
Temp. Ltr. Issued: 8/16/2001
Temp. Ltr. Expires: 9/30/2001
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
1000 W BOISE CIRCLE
BROKEN ARROW OK 74012

Phone #: (918) 994-8000
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
WILLIAM CHARLES CLARK JR MD 24842
MARCHEL W CLEMENTS DO 2945
RICHARD DRAKE DO 4066
KEVIN MICHAEL DUKES MD 19322
SCOTT JEFFREY DUNITZ MD 16459
RONALD GENE HOOD MD 16507
ANTOINE IBRAHIM JABBOUR MD 17674
BRIAN EUGENE LOVELACE MD 23525
YOGESH MITTAL MD 23844
PAUL DAVID PETERSON MD 17851
JAMES CHARLES SLATER MD 16203
KEITH LADON STANLEY MD 15232
WESLEY M STOTLER DO 3496
RICHARD DOYLE THOMAS MD 20842

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